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The Low
Back Pain Phenomenon:
Enigma
Or
The Elusive Obvious?
Part 1
By Sam Visnic NMT, L.M.T.
C.H.E.K. Practitioner Lv.3
Nutrition And Lifestyle
Coach Lv.2
I love that phrase “the
elusive obvious”. It is a
phrase that I took from
Moshe Feldenkrais. It refers
to the seemingly escapable,
but relatively obvious
solution that I am going to
let you in on in this
article series. The lower
back pain phenomenon seems
to be much more of an enigma
today than ever. Over 8 out
of 10 Americans will have it
over a lifetime. Back pain
sufferers spend millions of
dollars per year seeking
solutions from doctors,
surgeons, chiropractors,
massage therapists,
acupuncturists, and even
spiritual healers. Some of
them report success with
these therapies, while
others continue to seek
relief.
I have been working in the
health industry specifically
with back pain sufferers for
over 4 years now, and have
achieved a phenomenal track
record for helping
individuals eliminate back
pain with natural methods. I
have tried many methods, and
studied the works of many of
the top experts in the
field. Through my studies
and one-on-one work with
people, I have come to
realize the importance of 3
critical areas that must be
addressed in the back pain
sufferer in order to be
successful. You may have
heard of the elements
before, typically called the
“triad of health”
(originally coined by Dr.
George Goodheart). The triad
involves three parts:
Many will argue that one of
these facets is more
important than one of the
others, but I have not found
this to be true. I do agree
that at any given time, one
part of the triad may be the
lead stressor, and the
others to a slightly lesser
degree, but nevertheless all
important and must be
addressed.
The
Structure of Back Pain
Without a doubt, working
with back pain sufferers
from a structural standpoint
is the most common approach
amongst health care
professionals. More and more
research and information is
being brought to the
mainstream of fitness
programs with the focus on
the importance of posture
and muscle imbalances. Good
postural alignment is vital
to the health and well-being
of the entire body, both
inside and out! Correction
of muscular imbalances must
be the focus in any back
pain relief program.
What
Creates These Imbalances?
Imbalances can be created in
a number of ways. Here is a
short list of the most
common causes:
-
Repetitive activities
performed in the work or
sport environment
-
Jobs that require
sitting for long periods
of time.
-
Poor postural alignment
habits, including
“emotional postures”
-
Trauma, such as a car
accident, or sports
injury
-
Referral from internal
organs (causing muscular
inhibition)
-
Faulty gym training
programs (too much
stress on bench
pressing, crunches, etc.
without exercising the
opposing muscles)
Optimal
Posture
The pictures above represent
optimal postural alignment.
In the front view, all limbs
are parallel to the horizon.
The shoulders, pelvis, hips,
knees, and ankles are all in
alignment with each other.
In the side view, the head
and neck are positioned
directly over the center of
the pelvis, hip, knee, and
ankle joint. This allows the
body to efficiently
distribute forces equally
throughout the muscular
system. When optimal posture
is present, the least amount
of pressure will be imposed
on the spinal column and
nerves.
There are too many
mechanical influences on
back pain to mention here,
so I will focus on 3 key
areas that must be
addressed. These three areas
include the head/neck
complex, the pelvis, and the
foot/ankle complex.
Higher
Reflex Mechanisms
It is important to realize a
few things about the
structure of the body.
Everything in the body
affects everything. Every
muscle in the human body
serves a purpose in the
overall functioning of the
system. If, for whatever
reason, that muscle is not
allowed to or capable of
performing its function,
then another muscle or
muscles must compensate for
that deficiency. The second
thing is that there exists a
hierarchy of needs in the
human body. Some bodily
mechanisms are more
important than others in
terms of sustaining life.
For example, in the presence
of a breathing dysfunction,
there will be specific
compensation patterns in
posture that will not be
corrected until normal
respiratory function is
corrected first.
Why? Because you can live
your entire life with
postural imbalances, but you
can only go without
breathing for a few minutes.
In light of these facts,
there can be many factors
that influence how
structural dysfunction
exists in the body, and
therefore must be taken into
account during any
corrective work.
The
Head/Neck Complex:
The head and neck complex is
one of the most intricate,
and vastly complex areas of
the body. It contains many
key mechanisms which enable
the person to survive, such
as the visual center, the
auditory/vestibular system,
the jaw/masticatory system,
and the upper cervical
region. These systems
dynamically support the body
and all communicate
intimately with each other
to keep the body upright.
Have you ever noticed that
no matter how bad someone’s
posture is, even if they
have an advanced case of
scoliosis (lateral curve of
the spine), they always seem
to keep their eyes and ears
level with the horizon? In
primitive times this
phenomenon would be
essential in order to
balance the body and
effectively spot predators
and other safety/security
concerns.
In the case of head and neck
disorders, such as upper
cervical subluxation, TMJ
dysfunctions, visual
disturbances, and auditory
disturbances, the body will
always seek to balance
itself out, even at the
expense of the alignment of
everything below. What this
means is that many cases of
spinal dysfunction such as
scoliosis, excessive curves
or rotation of any spinal
segments or the pelvis can
directly or indirectly be
related to the mal-alignment
of any one of these
structures. Attempts at the
long-term correction of such
spinal mis-alignments could
prove to be futile in the
presence of dysfunctions in
the head/neck complex.
Visual
Signs Of Head/Neck Complex
Dysfunction:
The Pelvis
The pelvis contains the
center of gravity in the
body. It has approximately
39 major muscle attachments,
and it’s position directly
influences the curvature of
the lumbar spine and lower
body (legs, knees, ankles,
feet). The pelvis
communicates with the
head/neck complex very
closely. As the head/neck
position moves into faulty
positions in any direction,
the pelvis will compensate
accordingly to maintain the
body’s center of gravity. As
this happens, certain
muscles will take on the
increased weight load and
over time, become
overworked, and tired. The
pelvis is home to many of
the major imbalances that
can contribute heavily to
lower back pain. Faulty
training techniques,
imbalanced workout programs
(too many crunches, isolated
exercises, etc.), jobs that
require excessive amounts of
sitting, and overall poor
posture all contribute to
imbalances in the pelvis.
Visual
Signs Of Possible Pelvic
Dysfunction/Misalignment:
The
Foot/Ankle Complex
The feet are often
overlooked in many cases as
a source of chronic
dysfunction and pain in the
body. The alignment of the
feet and ankles are closely
related to the alignment of
the pelvis. When the pelvis
is tipped forward (anterior
pelvic tilt), this creates
internal rotation of the
legs and overpronation in
the ankle, thus leading to
flat feet. The opposite
effect can happen as well.
Foot and ankle dysfunctions
can also lead to mis-alignments
of the pelvis. The effects
of bad feet can be linked to
problems high up in the body
such as chronic neck tension
and upper cervical
subluxation. This is due to
the fact that in every step
that is taken, muscles must
accelerate, decelerate, and
stabilize forces in each and
every joint in order to
protect important structures
and maintain optimum
balance.
Visual
Signs Of Foot/Ankle
Dysfunction/Misalignment:
Correction
Measures
Correction of postural
imbalances can include a
wide array of techniques.
Muscles that are identified
as tight or too strong may
be relaxed through massage
or other manual therapy
techniques and stretching,
while muscles that are
identified as too weak and
lengthened must be
strengthened by releasing
the opposing muscles and
through corrective
exercises. Corrective
procedures must be done in
the proper ratios in order
to fully balance the body.
So, the first step involves
identification, then the
proper assignment of
corrective stretches and
exercises.
Corrective
Exercise Examples:
Horse Stance Horizontal
Corrective Exercise To
Strengthen Spinal
Stabilizers
Split Stance Corrective
Exercise To Re-Train Pushing
Pattern With Abdominal
Integration
As you can see, designing a
corrective exercise and
stretching program for the
chronic back pain sufferer
is no easy task (on my
part!). It involves a
detailed assessment of all
bodily structures and their
interaction on posture and
movement abilities. I
personally believe that the
lack of assessment depth is
the reason why many
traditional movement
therapies fail to provide
relief to many individuals
with chronic back pain, as
they simply don’t address
the root cause of the
problem!!
In the next part of this
article, I will discuss the
role of nutrition, hormonal
balance, internal organs,
and the influence these
areas have on the back pain
equation. See you for part
2! |
